Decision Making Tools

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Two group decision making tools frequently used by quality improvement teams to make decisions are Multivoting and Nominal Group Technique (NGT).

While idea-generating tools such as Brainstorming produce a list of possible alternatives, Multivoting and Nominal Group Technique help to identify the important or popular items or prioritize the items on a list. 

It is important to understand that not all decisions are made in a team situation. Of those decisions that are made by teams, not every one be made using these decision making tools.

Decision Making Tool Selection


Decision Making Tools Selection...

Try Multivoting if you need to:

  • Reduce a long list of ideas and assign priorities quickly and with a high degree of team agreement.
  • Identify the important items on a list.

Try Nominal Group Technique if you need a more structured approach to:

  • Generate, clarify, and evaluate a sizable list of ideas, problems, or issues.
  • Prioritize the items on a list.

What Is Multivoting


Multivoting is a group decision making tool used to reduce a long list of items to a manageable number by means of a structured series of votes. The result is a short list identifying what is important to the team.

When To Use It


Use Multivoting whenever a Brainstorming session has generated a list of items that is too extensive for all items to be addressed at once.

Because Multivoting provides a quick and easy way for a team to identify the most popular or highest priority items on a list—those that are worthy of immediate attention—this tool can be helpful when you need to:

  • Reduce a large list of items to a workable number quickly, with limited discussion and little difficulty.
  • Prioritize a large list without creating a situation in which there are winners and losers in the group that generated the list.
  • Identify the important or popular items on a large list.
multivotingMultivoting Decision Making

How To Use It


Follow these steps to conduct Multivoting:

Step 1 - Work from a large list of items developed by Brainstorming or another appropriate idea-generating technique.

Step 2 - Assign a letter to each item to avoid confusion of item designations with the vote tally.

Step 3 - Vote

  • Each team member selects the most important one-third (or no more than one half) of the items by listing the letters which appear next to those items. For example, if there are 60 items, each person should choose the 20 items (one third of the total) he or she thinks are most important.
  • Each team member may cast only one vote per idea and must cast all allotted votes.
  • Voting may be done either by a show of hands or by paper ballot when the team chooses to preserve confidentiality.

Step 4 - Tally the votes. Place a check mark next to each item for each vote it received. Retain the items with the most votes for the next round of voting. You can use the following Rule of Thumb for deciding how many items to eliminate in each round, depending on the size of the group:

  • If the team has 5 or fewer members, eliminate those items that receive 2 or fewer votes.
  • If the team has 6 to 15 members, eliminate all items that receive 3 or fewer votes.
  • If the team has more than 15 members, eliminate all items that receive 4 or fewer votes.

Step 5 - Repeat. In the second round, each person again selects the top one-third of the items. Repeat steps 3 and 4 until only a few items remain. Never multivote down to only one item. The items that were not identified as priorities should be retained as backup data or for future use by the team in its improvement efforts.

What is NGT


Nominal Group Technique is a weighted ranking method that enables a group to generate and prioritize a large number of issues within a structure that gives everyone an equal voice. The tool is called nominal because there is limited interaction between members of the group during the NGT process.

nominal group techniqueNGT Decision Making


When To Use Unit


When should a group use Nominal Group Technique?

When a team needs to create a list of options and rank them, using NGT effectively neutralizes the domination of the loudest person, or the person with the most authority, over the decision-making process. This tool can also help a team achieve consensus about the relative importance of issues. The final result may not be everyone's first priority, but they can live with it.

NGT is a good tool to use when dealing with controversial or emotional issues, or when a group is stuck. It is particularly useful when you need to:

  • Reduce the number of issues for easier handling.
  • Get input from all team members.
  • Rank items in priority order.

How To Use It


Nominal Group Technique consists of two parts

NGT PART I - The issue is defined and the team generates ideas.

  • Introduce and clarify the issue to be addressed by the team. Write the issue on a whiteboard where everybody can see it. Allow for clarification, but do not let the group engage in a discussion of the issue itself. Remember to define unclear terms.
  • Generate ideas to address the issue at hand. 

Working in silence, each team member writes down his or her ideas on a piece of paper. People should not confer with each other and should sit quietly until everyone finishes writing.

Depending on the complexity of the topic, 5 to 10 minutes should be allowed for the silent process. People need to have enough time to get the broad, general ideas down, but not enough to create long, detailed lists.

  • Collect the team's ideas. Each team member in turn reads out one of his or her ideas. Write each idea on the whiteboard. This round robin should continue until all of the ideas have been offered and recorded. There should be no discussion or side conversations during this part of the session.

NOTE: If post-its are available, you may want to ask the participants to write each of their ideas on a separate sheet and hand them in. You can display the ideas randomly, rather than writing them down. These post-itsTM can be used later to create an Affinity Diagram.

  • Clarify ideas. Read each idea out loud. If clarification is needed, the person who provided the idea should explain it now. This is an opportunity to clean up the wording of any unclear statements. Others may contribute if necessary.
  • Combine ideas. Combine like ideas when feasible, but only if both originators agree to it. If they cannot agree, leave the two ideas separate.

NGT PART 2 - The team makes the selection.

  • Assign a letter designation to each separate idea. As with Multivoting, the facilitator assigns a letter to avoid confusion with the vote tally.
  • Rank the ideas independently. Each team member writes down the items by their letter designations and assigns them a numeric value based on his or her judgment of what is most important and what is least important. The highest number is assigned to the most important idea and the lowest to the least important idea. For example, if there are 8 items lettered A to H, the most important receives an 8 and the least important, a 1.
  • Collate the rankings. The facilitator transcribes the team members' rankings onto a whiteboard, writing each number next to the corresponding idea.
  • Add the rankings. The facilitator adds the numbers across. The idea with the highest point total is the one of most importance to the whole team. It is the highest priority item.
  • Rewrite the list. The facilitator rewrites the list of ideas in the order of their importance to the team.
  • Perform a sanity check. Does the prioritization make sense?

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